Public-Private Partnership (PPP) for delivery of animal

Public-Private Partnership (PPP) for delivery of

animal health service

PPP model development and planning

Solomon Gizaw1* , Dagim Berhanu1, Fasil Awol2, Gewado Ayledo2, Barbara Wieland1

1 International Livestock Research Institute (ILRI), Addis Aba ba, Ethiopia

2 Ethiopian Veterinary Association (EVA), Addis Ababa, Ethiopia

May 2021

Component 2 of the HEARD project is implemented by

©2021 International Livestock Research Institute (ILRI) and Ethiopian Veterinary Association

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Citation: Gizaw, S., Berhanu, D., Awol, F., Ayledo, G. and Wieland, B. 2021. Public-private partnerships (PPPs)

for delivery of animal health service: PPP model development and planning. Nairobi, Kenya: ILRI.

Acknowledgements We sincerely thank the PPP regional taskforces, regional HEARD project components of

Amhara, Oromia and Somali regions and the regional livestock development offices for their

significant contributions in the development of alternative PPP models. This research was

conducted as part of HEARD project activities. The HEARD project is supported by the

European Union under the 11th European Development Fund, NIP Reference No:

FED/2017/040-392 with contributions from the CGIAR Research Program on Livestock

supported by contributors to the CGIAR Trust Fund. CGIAR is a global research partnership

for a food-secure future. Its science is carried out by 15 Research Centers in close

collaboration with hundreds of partners across the globe

(www.cgiar.org/URL:http://www.cgiar.org/about-us/our-funders/).

http://www.cgiar.org/URL:http:/www.cgiar.org/about-us/our-funders/

Contents Acknowledgements ................................................................................................................................ III

I. Background to PPP .......................................................................................................................... 1

1.1 Proclamations and rationalization road map .......................................................................... 1

1.2 The World Organization for Animal Health (OIE) .................................................................... 1

1.3 The HEARD project .................................................................................................................. 1

II. PPP model development process .................................................................................................... 1

2.1 Gap analysis ............................................................................................................................. 1

2.2 Site selection and field visits/consultation .............................................................................. 2

2.3 Regional PPP Taskforce formation .......................................................................................... 3

III. PPP models .................................................................................................................................. 3

Model I: Private vaccination service .................................................................................................... 4

Description of the model ................................................................................................................. 4

Partners and roles/responsibilities .................................................................................................. 5

Model II: Sanitary mandate with woreda private sector partners for vaccination service ................. 7



Model III: Sanitary mandate with linked regional-woreda-kebele private sector partners for

vaccination service .............................................................................................................................. 9



Model IV: Mobile clinical service ...................................................................................................... 11

Description of the model ............................................................................................................... 11

Partners and roles/responsibilities ................................................................................................ 11

Model V: Clinical service by linked regional-woreda-kebele private clinics ..................................... 13


Partners and roles//responsibilities .............................................................................................. 13

Model VI: Community-based women vaccinators for NCD control ................................................. 15


Partners and roles//responsibilities .............................................................................................. 15

Model VII: Strategic community-based endo- and ecto-parasite control by private service

providers ............................................................................................................................................ 17


Partners and roles/responsibilities ................................................................................................ 18

Model VIII: Leasing kebele public health posts to jobless veterinary graduates .............................. 19


IV. Business case ............................................................................................................................. 19

Private service providers ................................................................................................................... 19

Marketing .......................................................................................................................................... 20

Business viability................................................................................................................................ 21

V. Sustainability and success factors ................................................................................................. 26

Sustainability ..................................................................................................................................... 26

Needs, benefits and impacts ............................................................................................................. 27

Governance ....................................................................................................................................... 27

VI. Planning ..................................................................................................................................... 28

Households and Livestock populations in pilot sites ......................................................................... 28

Resource and budget requirements .................................................................................................. 28

Work plan .......................................................................................................................................... 29

Monitoring and evaluation ................................................................................................................ 34

Annex I: Priority diseases and health services......................................................................................... 0

Annex II: Willingness to pay for services ............................................................................................... 14

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I. Background to PPP 1.1 Proclamations and rationalization road map

Two proclamations issued by the Government of Ethiopia lay the policy basis for introducing

PPP in the delivery of animal health services. The “Public Private Partnership Proclamation

No. 1076/2018” issued on the 22nd of February 2018 establishes a favorable legislative

framework to promote and facilitate the implementation of privately financed infrastructure

projects by enhancing transparency, fairness and long-term sustainability. The major

objective of the proclamation is to create a favorable framework for promoting and facilitating

the implementation of privately financed projects to support Ethiopian economic growth. The

“Animal Diseases Prevention and Control Proclamation No. 267/2002” issued on 31st

January 2002 directly relates to PPP in animal health service delivery. The proclamation

article 17.3 and 17.4 state ‘the MoA shall create favorable conditions for the promotion of

private animal health service delivery’ and ‘the Ministry shall, based upon the nature of the

services, define the role and responsibilities of the public and the private sector in the

delivery of animal health services’.

Following Proclamation No. 267/2002, the Ministry of Agriculture produced Veterinary

Services Rationalization Road Map in 2014. The road map outlines a proposal for increased

participation of the private sector in veterinary service delivery. The road map is yet to be

ratified by the Government of Ethiopia.

1.2 The World Organization for Animal Health (OIE) The World Organization for Animal Health (OIE) is the international apex body providing the

scientific and technical concepts for PPP in the veterinary domain. The HEARD project

followed the OIE ‘Guidelines for Public-Private Partnerships in the veterinary domain’ for

designing alternative PPP models. The guideline outlines:

• the strategic rationale for PPP: the potential benefits and positive impacts of PPP in

delivering services in the veterinary domain and the political and organizational

commitments essential to delivering them,

• Alternative approaches: different PPP approaches and the principles and key

success factors for ensuring successful application of PPP to deliver sustainable

services in the veterinary domain, and

• Implementation guide: how to make successful PPP happen in practice.

1.3 The HEARD project The alternative PPP models designed and presented in this document are part of the HEARD

project Result 2: Technical competences (knowledge, skills and attitude) and incentives for

veterinary service providers improved to deliver better and rationalized services), Activity 2.1

Pilot the veterinary service rationalization roadmap and sub-activity 2.1.3 Pilot novel models

for veterinary service delivery involving public and private sector.

II. PPP model development process 2.1 Gap analysis

Gaps from service provider’s perspective: To assess the gaps in animal health services form

service providers perspective, two stakeholder workshops were organized. Twenty-five and

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41 participants attended the first and second workshops, respectively. The participants

represented the public and private veterinary service providers, educators, non-governmental

organizations, international organizations, and donors. By institution, EU, OIE (World

Organization for Animal Health), MoA, regional bureaus of agriculture from and HEARD

project component 1 coordinators from the three regions (Amhara, Oromia and Somali

regions), ATA, FAO, NVI, Gondar University, Haramaya University, Jigjig University, Brook

Ethiopia, private clinics and drug stores and a global service provider Zoetis were

represented.

The workshops aimed to discuss and prioritize gaps in veterinary service delivery in Ethiopia

and identify possible public-private partnership models to address these. The specific

objectives were to understand public-private partnership (PPP) and PPP typologies, map

gaps to possible PPP typologies and agree on way forward in defining and setting up PPPs.

The workshop was organized in three sessions. In the first part of the workshop, a series of

presentations were made to introduce the workshop’s aims and objectives and the tasks in

the three sessions of the workshop, the gaps identified in veterinary service delivery in the

first stakeholder workshop held in April, 2019, the principles and operations of the PPP

typologies, PPP experiences from Ethiopia, Kenya and globally presented from OIE. The

gaps identified included limitations in policy and strategy (policy makers attention, legal and

regulatory frameworks, vaccination strategy, extension service on animal diseases and

veterinary service, and disease reporting system) and poor access to services and inputs

(drugs in quantity, quality, variety and affordability).

For the second session of the workshop, participants were divided into four groups, each

group consisting of the different stakeholder categories (public, private and NGOs). Following

OIE guidelines, the groups exercised mapping of the gaps to possible PPP typologies based

on the presentations in session 1. An OIE handbook on PPP models reprinted with the

permission of OIE and with the support of the ILRI were distributed to each of the participants

to facilitate the exercise and for future reference in implementing PPP models. The third

session was devoted to discussing the gap-PPP typology mapping outcomes from group

works and finally on the way forward with the HEARD project PPP activity.

Gaps from livestock keepers’ perspectives and WTP for services: The base situation in

animal health service delivery and disease problems were assessed to target priority

diseases and services in the PPP models. The assessments were conducted in four woredas

in each of Amhara and Oromia regions using household surveys and in two woredas in

Somali region using FGDs. The assessment in Somali also included pastoralists willingness

to pay (WTP) for health services. The results are documented in two reports. A summary of

the priority diseases, status of health services and pastoralists’ WTP for services are

presented in Annex I and II.

2.2 Site selection and field visits/consultation Two woredas from each of Somali (Hargelle and Deghabour woredas), Oromia (Negelle Arsi

and Dire Inchini) and Amhara (Bati and Banja) were selected for piloting alternative PPP

models. See the woreda sin subsequent section of this document. Field visits were made to

the woredas and kebeles to provide feedbacks on disease priorities identified by the baseline

surveys and FGDs (Section II.1) in their woredas and assess the opportunities and

constraints for introducing/piloting PPP models for improved delivery of health services. The

consultations were held with the heads of woreda livestock offices and veterinary

departments, private service providers and livestock keepers.

Page | 3

2.3 Regional PPP Taskforce formation Regional PPP taskforces consisting of 12-13 members, led by a chairman from the public

sector and a secretary from the private sector, were officially formed in Somali, Oromia and

Amhara regions. The task force membership consisted of the private service providers

(clinics, drug shops, veterinary input suppliers), livestock producers, public health service

providers (veterinarians from regional and woreda offices including regional health service

directors), laboratories and Universities. ToRs were developed for the taskforce. The

taskforce formation is documented in a report (link). The tasks include:

• The task force will serve as a platform for communication between the public and

private sector

• Identify the challenges faced by the private sector and present for policy makers

• The task force will oversee the activity of HEARD project in relation to piloting of

public-private partnership models

• Suggest ideas on PPP models for policy formulation and regulation.

• Identify the needs for capacity building

• Identification existing PPP models and evaluate their efficiency and effectiveness

• Monitoring and evaluation of the PPP activities

III. PPP models According to their stipulated tasks in the ToR, namely developing PPP models feasible for

the regions, the taskforces identified eight models (Table 1). Service providers from the

public and private sectors from the selected pilot woredas also participated in these sessions.

The identified models were described, and detailed plans were laid following OIE guidelines.

The taskforces also described the benefits/impacts, opportunities and barriers, resource

requirements, service fees, and work plans.

The pubic-private partnership arrangements discussed during the regional PPP taskforce’s

workshops in the three HEARD project regions were categorized and described into eight

PPP models (Table 1). The criteria used to classify the arrangements were the service type

or objective of the PPP arrangement, the types, numbers and interactions among the private

sector partners, the public sector partners involved, and the interaction between the public

and private sector partners (e.g. funding, …).

Table 1. PPP models identified by regional PPP taskforces

PPP models Region Woreda kebele Services/objectives

Model I: Private

vaccination service

Amhara Banja Akena rural kebele; Koso

Ber town & environs

Rabies, Anthrax,

Black leg vaccination

Amhara Bati Cacatu O. & B.

Pasteurellosis

Oromia Dire Inchini Waldo O. & B.

Pasteurellosis

Negelle

Arsi

Gambelto O. & B.

Pasteurellosis

Page | 4

Model II: Sanitary

mandate with

woreda private

sector partners for

vaccination service

Somali Deghabour Bulale Camel pox, O.

Pasteurellosis

Model III: Sanitary

mandate with

regional-woreda-

kebele private sector

partners for

vaccination service

Somali Hargelle Oman Camel pox,

Pasteurellosis,

Sheep and goat pox,

CCPP

Model IV:

Mobile

clinical service

Oromia Dire Inchini Waldo hindho, Clinical service,

Negelle

Arsi

Gambelto Clinical service

Model V:

Clinical

service by regional-

woreda-kebele

private clinics

Somali Hargelle Oman Clinical service

Model VI:

Community-based

women vaccinator

for NCD control

Amhara Banja Akena kebele, Banja

town & environs

NCD vaccination

Model VII: Strategic

community-based

endo- and ecto-

parasite control by

private service

providers

Somali Deghabour Bulale Ectoparasite control

Oromia Dire Inchini Waldo hindho, strategic deworming

& spraying

Model VIII: Leasing

kebele public health

posts to jobless

veterinary graduates

Amhara Clinical service

Model I: Private vaccination service Description of the model Vaccination in Ethiopia is exclusively provided by the public sector. This model involves a

collaborative partnership between the public and the private sector. The public sector

designates the private sector to provide vaccination service for specific diseases and in

specific geographic locations (kebeles). The public sector does not fund the service but

would set enabling environment for the private sector including authorizing/certifying the

service, facilitating access to facilities and input delivery as appropriate, and monitoring and

evaluating the services. The private sector provides the service to livestock producers at

Page | 5

cost. The model will be piloted in Oromia and Amhara regions in three woredas and kebeles

shown in Table 1. The roles of the public and private partners may vary across the pilot sites.

The various partners involved in the PPP model (Table 2) will facilitate and coordinate the

supply chain for inputs and services, community mobilization and coordination of the

vaccination program and creation of enabling environment and regulation/quality control of

the services provided. The roles and responsibilities of the partners are shown in Table 2.

Catalyzing the PPP model: PPP for the delivery of services in the veterinary domain does not

exist in Ethiopia. Thus, certain costs need to be covered during the initial phase by an

external source till the PPP arrangement takes root. However, arrangements need to be

made to recover costs within short duration of the pilot project to lay the ground for a

sustainable PPP model. To catalyze the PPP arrangement, and till farmers adopt strategic

preventive measures, Voucher system will be introduced for the first six months to share the

cost of vaccination service between HEARD project and the farmer as well as to strengthen

private clinical services by creating favorable business environment. The cost shares are

shown in Table 14. The lab costs for pre- and post-vaccination serological tests will also be

covered by the HEARD project.

Partners and roles/responsibilities Table 2. Partners/stakeholders and roles for private vaccination service in Amhara (Banja

and Bati woredas) and Oromia (Dire Inchini and Negelle Arsi woredas) regions, Ethiopia

Partners/stakeholders Roles/responsibilities

HEARD project Provide voucher to share the cost of vaccination with farmers

for the 1st 6 months

Awareness creation and training for farmers on the role of

vaccination in disease prevention and control

Supporting diagnostic capacity of the regional laboratory

Supporting private actors’ capacity to implement the model

effectively

Settling payment for the private sector based on vouchers

provided

Oromia and Amhara

PPP

set enabling environment and regulations for the private

vaccination service.

taskforces M & E of implementation of PPP model

Oromia and Amhara

regional


vaccination service

Livestock office Certification/temporary waiver for the participation of private

actors in the woreda vaccination program for specified locations

and diseases

M & E of implementation of PPP model

Woreda livestock offices Enforce implementation of regulation

Page | 6

Procure & Provide vaccines (Banja only) & vacc calendar for the

private clinics

Provide Cold chain facilities for vaccine storage

Support mobilization for vaccination campaign

Monitor the vaccination campaign

Kebele administrations,

health

Consult with the community on the vaccination calendar

posts and livestock

offices

Collect vaccination costs from farmers in advance & mobilize

vaccination campaign

Work with HEARD project on awareness creation activity

Support M & E activity in collaboration with concerned partners

Regional laboratories Asella Lab - seroprevalence & seroconversion tests in Dire

Inchini & Negelle Arsi

Kombolcha Lab - Seroprevalence & seroconversion tests in Bati

woreda

Bahir Dar Lab - Seroprevalence & seroconversion tests in Banja

woreda

Involve in M & E of model implementation

Farmers Actively participate in the training program

Actively participate in vaccination campaign to insure proper

unitization of vouchers

Share the cost of vaccination with ILRI/EVA and pay their share

to the private sector after vaccination

Private drug

shops/clinics

Procure vaccines for PD (Bati and Dire Inchini woredas)

Procure Rabies vaccines

Provide vaccination service on the day of campaign to the

farmers

Provide extension service for the farmers

Provide information of the vaccination campaign to the woreda

animal health department

Collect vaccination cost shared by the farmers.

Collect vouchers properly for vaccination service provided to the

farmers

Page | 7

Provide voucher to ILRI/EVA receipt, and attachment for

purchased vaccine from NVI on purchase date and any other

necessary information before payment

Report any observed animal disease outbreak to the woreda

office

NVI Produce and supply vaccine at cost

Model II: Sanitary mandate with woreda private sector partners for vaccination service Description of the model The typology of this model assumes transactional modality. The public sector contracts the

private sector at woreda and kebele level to provide vaccination service for specific diseases

and in specific geographic locations (kebeles). Vaccines will be provided by the public sector

up to woreda level to private clinics, who would link with kebele animal health posts and/or

kebele human health clinics for cold chain facilities and with CAHWs at kebele level to

provide the vaccination services. The model will be piloted in Somali region.

There is a persistent trend to deliver free vaccination services in the region. However, this

arrangement may not be sustainable, especially for List B (production) diseases for which

vaccines are provided at higher costs. In the current proposed PPP arrangement, vaccination

will be provided to pastoralists at cost for both categories of vaccines, though vaccines for

“List A diseases”/transboundary diseases are provided for free as a policy. This PPP

approach requires a strong cooperation of concerned actors to create public awareness

towards cost-recovery of vaccination services. The pastoralists expressed willingness to pay

for vaccination services (See Annex 1).

The public sector creates enabling environment for the private sector including

authorizing/certifying the private partners vaccination service, facilitating access to facilities

and input delivery as appropriate, and monitoring and evaluating the services (Table 7).

Catalyzing the PPP model: As a policy, vaccination for certain national priority diseases is

provided free of charge in Ethiopia, such as in diseases eradication programs. The cost of

the vaccination program in such cases is covered by the government. For the pilot phase of

the HEARD project, the pastoralists are encouraged to contribute 20-30% of the costs. Their

contribution is expected to grow in subsequent vaccination seasons. The HEARD project’s

share of the cost of List A diseases will be taken over by the public sector at the end of the

project. The lab costs for pre- and post-vaccination serological tests will also be covered by

the HEARD project.

Partners and roles/responsibilities Table 7. Partners/stakeholders and roles for private vaccination service in Deghabour

woreda of Somali region of Ethiopia


HEARD project Provide voucher to share the cost of vaccination with

pastoralists for the 1st 6 months

Page | 8

Awareness creation and training for pastoralists on the role of




effectively


provided

Somali region PPP set enabling environment and regulations for the private


taskforce M & E of implementation of PPP model

Oromia and Amhara

regional


vaccination service



and diseases



Procure & Provide vaccines & vacc calendar for the private

clinics





health


posts and livestock

offices

Collect vaccination costs from pastoralists in advance &

mobilize vaccination campaign



Jigjiga Regional

laboratory

Blood sampling and seroprevalence & seroconversion tests


Pastoralists Actively participate in the training program





Page | 9

Private drug

shops/clinics

Link with CAHWs to provide vaccination service on the day of

campaign

Provide extension service for the pastoralists



Collect vaccination cost shared by the pastoralists.


pastoralists





office


Model III: Sanitary mandate with linked regional-woreda-kebele private sector partners for vaccination service Description of the model The typology of this model assumes a transactional modality. The public sector commissions

big private sector partners with high level of capacity at regional level to provide vaccination

services for specified diseases and in specified geographic locations (kebeles) in Somali

region. The regional private actor contracts its private partners at woreda level who in turn

contract partners at kebele level (CAHW) to provide the vaccination service.

The PPP arrangement is that vaccines will be procured by the public sector from the NVI and

provided at NVI cost to the regional private partner, who will transport the vaccines to the

woreda private partner, who will in turn to CAHWs.

A business arrangement is agreed among the private partners at the various administrative

level. Although vaccination is normally provided free of charge in Somali region, pastoralists

are encouraged to pay for the service in the current PPP arrangement. The HEARD project

will play a catalyzing role as described under Model II.

Partners and roles/responsibilities Table 8. Partners/stakeholders and roles for private vaccination service in Hargelle woreda of

Somali region of Ethiopia


HEARD project Provide voucher to share the cost of vaccination with

pastoralists for the 1st 6 months

Awareness creation and training for pastoralists on the role of



Page | 10


effectively


provided

Somali region PPP set enabling environment and regulations for the private


taskforce M & E of implementation of PPP model

Somali regional set enabling environment and regulations for the private

vaccination service



and diseases




clinics





health


posts and livestock

offices

Collect vaccination costs from pastoralists in advance &

mobilize vaccination campaign



Jigjiga Regional

laboratory

Blood sampling and seroprevalence & seroconversion tests


Pastoralists Actively participate in the training program





Kulmiye vet service

cooperative

Coordinate the vaccination activity and business arrangement

from the private sector side

Deliver vaccines and drugs to Hargelle woreda

Page | 11

Private drug

shops/clinics at

Link with CAHWs to provide vaccination service on the day of

campaign

Woreda level Provide extension service for the pastoralists



Collect vaccination cost shared by the pastoralists.


pastoralists





office


Model IV: Mobile clinical service Description of the model The proposed mobile clinic service PPP model can be categorized as a transformative

modality following OIE PPP classification. This involves partnership between the public

sector providing enabling environment and regulatory service, the private sector providing

mobile clinical service to villages on request and the livestock producers paying for the full

cost of the service. The model is planned to be piloted in Oromia region, Dire Inchini woreda.

• The reginal and woreda livestock offices and regional PPP taskforce will set an enabling

environment. This includes facilitating and supporting the private service provider to

obtain license for mobile clinical service and drug sales since the service providers in the

pilot woredas are all licensed as drug shops. The other option would be to get a waiver

from the woreda office for the drug shop to practice mobile clinical services.

• The woreda animal health unit will enforce implementation of regulation and quality

control of services

Catalyzing the PPP model: The private service provider will be strengthened (See Planning

section, resource requirements).

Partners and roles/responsibilities Table 9. Partners/stakeholders and roles for private mobile clinic service in Dire Inchini

woreda of Oromia region of Ethiopia

Partners Specific

NAMES

Role

ILRI/EVA Supporting the private sector with equipment

Awareness creation on disease prevention and control

strategies (farmer training)

Page | 12

Refresher training for the private sector

Provide voucher for strategic deworming campaign for

the 1st intervention year

Settling payment for the private sector based provided

vouchers

PPP Task force

and regional

livestock health

office

Work in setting supportive regulation required for the

PPP

Certification of the private sector involved in mobile

clinical service delivery with renewable certificate

allowing to work within specified area

Woreda animal

health department

Dr. Hachalu

Tasamma

Enforce implementation of regulation

Provide spray and deworming calendar for the private

sector

Support mobilization for deworming and spray

campaign

Monitor the service provided by the private sector

Kebele

administration

Waldo hindho

kabale

administrations

and DA

Work on controlling illegal mobile clinical service

providers

Discuss with the community to decide on-deworming

and spray campaign date.

Work with ILRI/EVA on awareness creation activity

Support monitoring and evaluation process by

collaboration with ILRI/EVA

Mobilize community for community-based deworming

and ecto-parasite spray campaign

Farmers Pay for the clinical service they are provided by the

private sector

Actively participate in the training program and

deworming campaign

Private sector

(specify name of

business)

Teferi kebede

drug shop and

mobile clinical

service

Procure drugs

Provide quality, timely and ethical mobile clinical service

for the farmers


Charge farmers for the service he provides, except for

strategic deworming program

Collect vouchers properly for deworming service he

provides to the farmers

Page | 13

Provide voucher to ILRI/EVA, receipt for anthelmintic

purchase; any other necessary information before

payment

Regional

laboratory

Assela Pre and post treatment EPG assessment

Model V: Clinical service by linked regional-woreda-kebele private clinics Description of the model The typology of this model assumes a transformative modality. The public sector role is to

create enabling environment for the private sector to provide all clinical services in

designated kebeles in Somali region. The regional cooperative clinics (Kulmiye) will supply

clinical supplies (mainly drugs) to woreda clinics who are linked to kebele CAHWs who will

deliver the clinical services to pastoralists.

The public sector also creates enabling environment for the private sector including

authorizing/certifying the service, facilitating access to facilities (e.g. health post facilities in

kebeles), and monitoring and evaluating the services.

Partners and roles//responsibilities Table 10. Partners/stakeholders and roles for private clinical service in Somali region of

Ethiopia

Partners Specific

NAMES

Roles and responsibilities

ILRI/EVA Covering cost of vaccination for the pastoralists

In collaboration with regional governed, awareness

creation on the role of vaccination in disease prevention

and control (pastoralists); Technical capacity building for

vaccine delivering personnel;

Supporting diagnostic capacity of the regional

laboratories

Vaccination equipment and protective tools

PPP Task force Work in setting supportive regulation required for the

PPP

Oversee the PPP activities in line with the ToR of the

taskforce

Recognition of the regional taskforce; recognition for the

private sector involved in clinical services and

Page | 14

Regional

livestock

Resources office

(Bureau)

vaccination program with renewable certificate for

specified disease within specified area

In collaboration with reginal Lab, monitor and follow-up

vaccination effectiveness

In collaboration with EVA/ILRI, awareness creation for

pastorals about the importance of vaccination, the need

for gradually engage the community in cost recovery of

vaccination services; and capacity building for veterinary

personnel;

Supply List A vaccines for the project woredas

Woreda

livestock and

pastoral office


Provide vaccination calendar for the private sector; Also

closely monitor Woreda vet drug shops and CAHWs to

ensure proper storage and handling of vaccines



Supply list B vaccines for private sectors, while list A

vaccines are to be supplied by regional livestock bureau

Kebele

administration

and health

sector staff

Mobilize vaccination campaign

Discuss with the community to decide on vaccination

date


Support monitoring and evaluation process in

collaboration with ILRI/EVA and regional laboratories

Regional

laboratories

Conduct sero-prevalence (pretest) and seroconversion

test for the specified diseases

Pastoralists Actively participate in the training (awareness creation)

program; mobilize their animals for clinical services;

Actively participate in vaccination campaign to insure

proper unitization of vouchers

Kulmiye vet-

agri-

cooperative

(Dr. Ismail

Mahmed-

Cooperate with regional and Woreda livestock office to

facilitate vaccine supply;

Provide vaccination service on the day of campaign to

the pastoralists

Provide monthly report and other necessary information

about the vaccination campaign to the woredas livestock

office

Page | 15

Private sector

(specify name of

business)

General

Manager)

Provide voucher to ILRI/EVA, receipt and attachment for

purchased vaccine from NVI on purchase date and any

other necessary information before payment issuance.

Supply various drugs for Woreda private clinics (the two

pharmacies above)

Iftin Vet

Pharmacy

(Ismail Ali

Ahmed) and

Roti Vet Drug

shop (Ahmed

Abdi Rage)

➢ Receive vaccines and drugs from Kulmiye clinic

and supply to CAHWs to serve the community;

➢ Store vaccines in appropriate cold chain

(collaboration with Woreda Public or Private

medical clinics/Hospitals)

NVI Produce and make available vaccines, based on

regional demand

Model VI: Community-based women vaccinators for NCD control Description of the model The typology of this model assumes a contractual partnership between the private and public

sectors. The public sector recruits and trains women residing within the communities (where

the service is planned to be delivered) to provide community-based vaccination service for

the control of NCD at predetermined fees. The women are also provided with vaccination

kits. The model will be piloted in Amhara region, Banja woreda, Akele rural kebele and the

woreda capital Koso ber. Planning and implementation of this activity is coordinated with a

similar activities by the regional HEARD component. Coordination with other similar projects

by the MoA and Kayeema project is underway.

The public sector also creates enabling environment for the private sector including

authorizing/certifying the service, facilitating access to facilities (e.g. health post facilities in

kebeles), procuring and delivering vaccines, and monitoring and evaluating the services.

• The regional livestock office procures and delivers vaccines to women vaccinators

through woreda and kebele livestock offices

• Cold chains are provided by the woreda livestock offices

• Revolving fund and vaccination gear to be provided by the HEARD project (Vaccination

needles (12 and 16 G), Ice box, Needle holder, Forceps, Gawn)

Partners and roles//responsibilities Table 11. Partners/stakeholders and roles for NCD vaccination by women vaccinators in

Amhara region of Ethiopia


HEARD project Provide voucher to share the cost of vaccination with farmers

for the 1st 6 months

Page | 16

Awareness creation and training for farmers on the role of


Recruit women vaccinators (Amhara HEARD)

Train and provide necessary equipment for women vaccinators



effectively


provided

Amhara PPP set enabling environment and regulations for the private


taskforces M & E of implementation of PPP model

Amhara regional Coordinate NCD vaccination by different stakeholders in the

region


vaccination service

Livestock office Certification for the participation of private actors in the woreda

vaccination program for specified locations and diseases




vaccinators




health


posts and livestock

offices

Collect vaccination costs from farmers in advance & mobilize

vaccination campaign



Bahir Dar University Train women vaccinators

Regional laboratories Bahir Dar Lab - Seroprevalence & seroconversion tests in Banja

woreda


Farmers Actively participate in the training program

Page | 17





Women vaccinators Collect vaccines from regional or woreda Livestock office

Provide vaccination service on the day of campaign to the

farmers




Collect vaccination cost shared by the farmers.


farmers





office


Model VII: Strategic community-based endo- and ecto-parasite control by private service providers Description of the model The model involves partnership between the public livestock offices of Dire inchini Woreda in

Oromia region and Deghabour woreda of Somali region with clinics/drug shops in the woreda

towns to provide strategic community-based deworming and spraying against external

parasites. The public sector facilitates enabling environment and regulatory service.

• The reginal and woreda livestock offices and regional PPP taskforce will set an enabling

environment. This includes facilitating and supporting the private service provider to

obtain license for mobile clinical service (especially at Dire Inchini). The other option

would be to get a waiver from the woreda office for the drug shop to practice mobile

clinical services.

• The woreda animal health unit will enforce implementation of regulation (quality control of

services) including providing calendar for strategic deworming and spraying program.

• The kebele animal health posts mobilize farmers for deworming campaigns and collect

deworming fees from farmers in advance.

Page | 18

• Regional laboratories will assess the effect of strategic deworming program on animal

health and production. In addition, they will consult the kebele on strategic deworming

calendar.

Catalyzing the PPP model: PPP for the delivery of services in the veterinary domain does not

exists in Ethiopia. Thus, certain costs need to be covered during the initial phase by an

external source till the PPP arrangement takes root. However, arrangements need to be

made to recover costs within short duration of the pilot project to lay the ground for a

sustainable PPP model. To catalyze the PPP arrangement and till farmers adopt strategic

preventive measures such as deworming which is to be introduced for the first time into the

pilot sites, 50% of service fees will be by the HEARD project for the first six months via

voucher system. The contribution of HEARD will decline progressively while the farmers’

share will increase by 50% in subsequent seasons (i.e. HEARD farmer contributions will be

25%:75% in 2nd deworming/spraying season). The lab costs for testing the effects of the

interventions will also be covered by the HEARD project.

Partners and roles/responsibilities Table 12. Partners/stakeholders and roles for strategic GIT and external parasite control in

Oromia and Somali regions of Ethiopia

Partners Roles and responsibilities

HEARD

Sharing cost of acaricide and dewormer through voucher

system

Awareness creation on the role of ectoparasite control in

animal production and health (farmer training)

Strengthen capacity of private service providers

PPP Task forces

Work in setting supportive regulation required for the PPP

Over sees entire PPP work within the region

Regional livestock office

(Bureau)

Recognition of the private sector involved in the program

with renewable certificate


Deghaboure and Dire Inchini

woreda animal health

department

Provide deworming and spraying calendars to private

service providers in consultation with the regional offices

and farmers/pastoralists

Support community mobilization and Monitor the

deworming/spraying campaign

Kebele administration and

health sector staff

Mobilization of the campaign

Discuss with the community to decide on the campaign

date


Support monitoring and evaluation process by

collaboration with ILRI/EVA

Page | 19

Pastoralist and farmers

Actively participate in the training program

Actively participate in the campaign to insure proper


Private sector

Procure supplies

Provide deworming and acaricide spraying service on the

day of campaign to the pastoralist

Provide report and other necessary information and of the

campaign to the woredas animal health department

Provide voucher to ILRI/EVA any other necessary

information before payment

Model VIII: Leasing kebele public health posts to jobless veterinary graduates Description of the model The model involves leasing the public kebele health posts to jobless young veterinary,

preferably residing in the kebele, graduates to provide animal health services. The services

may include clinical services, and vaccination and health extension services in collaboration

with the woreda public clinics. The model is proposed by Amhara PPP taskforce.

This modality entails major changes and needs approval by the regional government council.

The region’s PPP taskforce is tasked with the following tasks:

• Inventory of jobless graduates in collaboration with the EVA

• Alternative approaches for the transfer of health posts to private practitioners

• Advocating and lobbying the PPP model concept to government stakeholders

IV. Business case Private service providers The PPP models are designed based on the principles of profit-making businesses.

However, the models involve a strong partnership between the private and the public sector

which includes certification of the private partners’ service, support with facilities the private

sector lacks, and monitoring and evaluation of the private partners services by the public

sector in collaboration with the PPP taskforces. Most of the private service providers are

licensed as drug shops and cannot provide clinical services legally, including mobile clinical

services. The regional livestock offices offered a waiver for such service providers.

The private service providers were selected by the regional livestock offices HEARD project

component based on their capacities to provide the services contracted by the public sector.

In some cases, like in Akana Kebele of Amhara region, the only available private service

provider was included. Descriptions of the private partners are shown in Table 13.

Table 13. description of private service providers

Page | 20

Region Woreda Kebele Business

name PPP model PPP Services

Somali

Deghabour

Bulaleh

Al Nasri Vet

Pharmacy Model II Vaccination

CAHW Model VII

Strategic

deworming/spraying

Model V Clinical service

Hargelle Oman

Kulmiye Vet-

Agri service

coop.

Model III Vaccination

Iftin Vet

Pharmacy Model V Clinical service

CAHW

Oromia

Dire Inchini

Waldo

Hindu

Teferi Vet Drug

shop

Model I Vaccination

Model IV Mobile clinical service

Model VII Strategic

deworming/spraying

TBD Sabena Vet

Clinic *

Model I Vaccination


Model VII Strategic

deworming/spraying

Negelle Arsi Gambelto Negesso vet

Clinic *

Model I Vaccination


Amhara

Banja

Akana

Desalew Vet

Clinic

Model I Vaccination

Model V Kebele-based Clinical

service

Two Women

vaccinators Model VI Vaccination

Bati Cacatu Gerbaba Vet

drug shop Model I Vaccination

Bahir Dar zuria Town & 5

Kebeles

Netsanet Vet

Clinic ** Model I Rabies vaccination

* Clinics yet to be established (Sabena clinic belongs to the PPP Award winner)

** This pioneer private vaccinator whose practice was identified as one of the PPP models

was recommended by the taskforce meeting group to be included

Marketing The procurement of inputs for the services is described under section IV (‘PPP Models’). The

HEARD project will contribute to the strengthening of the private service providers with the

necessary equipment/instruments to provide effective services (this is essential as most of

the service providers are drug shops and lack the equipment for clinical services).

Page | 21

The costs of services incurred by the livestock keepers were calculated by the taskforces in

the presence of the service providers, experts and directors from the woreda and regional

livestock offices. The costs are calculated based on the costs of inputs plus service charge

by the service provider (Table 14). Pastoralists/farmers are encouraged to contribute to 20-

30% of the costs in the first vaccination season, which will increase in subsequent seasons.

Business viability The market volume for the private service providers is estimated as the number of livestock

in the pilot kebeles (Table 15). It is expected that the service providers will have sufficient

markets to survive as a viable enterprise. The percent of the livestock population assumed to

be covered in vaccination, clinical services, and strategic deworming/spraying were 90%,

20%, and 50%. The market volume could increase in the next season and service providers

are encouraged to expand their businesses to neighboring kebeles in consultation with the

livestock offices.

The profitability of the businesses is confirmed by the cost-benefit analysis for the service

providers (Table 15) which shows medium to high net revenue, except for Model IV. The

businesses are profitable even when they bear the cost of vaccine transport from NVI is

included (Table 15) although during the project period vaccines are procured by the livestock

offices. In the case of Models involving more than one service provider, the partners need to

establish business relations and agreements which includes profit sharing of their joint

business. The taskforce suggested 70:30% profit shares between woreda clinics and

CAHWs in the case of Model II.

Page | 22

Table 14. Input costs to service providers and service costs to livestock keepers and shares1 of HEARD project and livestock keepers

Inputs and costs Sale price/animal (input cost + service charge, or gross sale price) Cost share (%)

Inputs Species

Cost/head

Dire

Inchini

Negell

e Bati Banja

Degha

b Hargelle

Bahir

dar

HEAR

D

Farmer/pastoralis

t

Pasteurellosis

vaccine Sheep/goat 0.5 1.5

1.5

5 3.5 4.5

703 30

Pasteurellosis

vaccine cattle 1.5 3.00

3.0

0

703 30

Sheep/goat pox Sheep/goat 1.5 703 30

Camel pox Camel 0.5 5.5 7.5 703 30

CCPP Sheep/goat 0.5 703 30

Blackleg vaccine cattle 1.6 3.10 3.1 703 30

Anthrax vaccine cattle 0.6 2.10 2.10 2.1 703 30

Rabies vaccine dogs 20.00 25.00 50 100 604 40

NCD vaccine chicken 0.50 1.00 0 100

Oxy (long acting) cattle/camel 18.75 45.00

15-

20%2 33.00

15-20% 2

0 100

small

ruminant 3.00 25.00 15-20% 19.5 15-20%

0 100

Penistrip cattle/camel 39.38 66.45 15-20% 57.00 15-20% 0 100

small

ruminant 6.30 27.15 15-20% 25.50 15-20%

0 100

dewormer cattle/camel 5.33 8.10 25.00 50 50

Page | 23

small

ruminant 2.50 5.00 15.00

50 50

acaricide cattle/camel 2.00 4.00 6.05 50 50

small

ruminant 1.25 3.00 6.05

50 50

1 Livestock keepers share of costs will increase from 2nd vaccination season onwards until 100% cost recovery by end of project

2 Service cost = cost of input plus 15-20% of costs as service charge

3 Share of farmers increases to 60-70% in the 2nd vaccination season, and continue to increase

4 Villages: 40% HEARD, 60% and 100% cost recovery in Towns. Farmers’ share increases in 2nd vaccination season

Table 15. Cost-benefit analysis for private service providers

Costs

Revenue

Model Woreda Service Market volume Input Labor Vet time Transport to NVI Transport to kebele Gross revenue Net revenue

I Dire Inchini O. Pasteurellosis 5400 2700 540 900 452 540 8100.00 2967.62

B. Pasteurellosis 3000 4500 300 500 452 300 9000.00 2947.62

Negelle Anthrax (Bovine) 9870 5922 987 1645 679 987 20727.00 10507.43

Blackleg (Bovine) 9870 15792 987 1645 679 987 30597.00 10507.43

Bati O. Pasteurellosis 25344 12672 2534 4224 679 2534 38016.00 15372.63

B. Pasteurellosis 3421 5132 342 570 679 342 10263.00 3198.56

Banja Rabies 725 14500 73 121 1407 0 36250.00 20149.52

Anthrax (Bovine) 3296 1978 330 549 1407 330 6921.60 2328.32

Page | 24

Blackleg (Bovine) 3296 5274 330 549 1,407 330 10217.60 2328.32

II (Deghabour) Camel pox 14152 7076 1415 2,359 3,782 1,415 77836.00 61788.79

O. Pasteurellosis 35300 17650 3530 5,883 3,782 3,530 123550.00 89174.52

III (Hargelle) Camel pox 22621 11311 2262 3,770 3,107 2,262 169657.50 146945.49

Sheep/goat pox 28000 42000 2800 4,667 3,107 2,800 126000.00 70626.19

CCPP 17000 8500 1700 2,833 3,107 1,700 76500.00 58659.52

Bovine Pasteurellosis 2641 3962 264 440 3,107 264 19807.50 11770.49

IV Dire Inchini Oxy (Bovine) 1080 20250 0 7,500 63 108 48600.00 20679.50

Oxy (ovine) 600 1800 0 7,500 63 60 15000.00 5577.50

Penistrip (Bovine) 1080 42525 0 7,500 63 108 71766.00 21570.50

Penistrip (ovine) 600 3780 0 7,500 63 60 16287.00 4884.50

V Deghabour Oxy (camel) 2830 53070 0 7,500 113 283 93403.20 32437.66

Oxy (ovine) 7000 21000 0 7,500 113 700 136500.00 107187.50

Penistrip (camel) 2830 111447 0 7,500 113 283 161332.80 41990.26

Penistrip (ovine) 7000 44100 0 7,500 113 700 178500.00 126087.50

VI Dire Inchini Deworming (Bovine) 4050 21587 2430 2,250 113 810 32805.00 5616.00

Deworming (Ovine) 2250 5625 1350 2,250 113 450 11250.00 1462.50

Acaricide (Bovine) 4050 8100 2430 2,250 113 810 16200.00 2497.50

Acaricide (Ovine) 2250 2813 1350 2,250 113 450 6750.00 -225.00

Deghabour Deworming (Bovine) 7076 37715 4246 2,250 113 1,415 176900.00 131161.62

Deworming (Ovine) 17500 43750 10500 2,250 113 3,500 262500.00 202387.50

Page | 25

Acaricide (Bovine) 7076 14152 4246 2,250 113 1,415 42809.80 20634.50

Acaricide (Ovine) 17500 21875 10500 2,250 113 3,500 105875.00 67637.50

VII Banja NCD vaccination 5619 2810 0 750 250 0 5619.20 1809.60

Page | 26

V. Sustainability and success factors Sustainability The models were developed and endorsed with full and active participation of

representatives from the public and private sectors in the regional PPP taskforce. The

taskforces included members from the regional and woreda livestock offices and the private

sector. The discussions included details including fees for different services and quality of

services. The following were listed as barriers to introduce the PPP models:

• Supportive Policy/regulatory environment

o National PPP proclamation encourages privatization of and partnership with the

private sector for provision of services

o Some efforts by the government to engage private enterprises in the delivery of

some vaccines (E.g. Rabies vaccines being delivered by private clinic holder in

and around Bahir Dar)

o No supportive legal framework for the private sector to participate in vaccination

services

o Absence of regulation for vaccination services by private service providers with

drug shop license

• Barriers in Policy/regulatory environment

o Free vaccine services for some diseases known as “List A diseases” in Ethiopia

(e.g. NCD vaccine and others)

o Absence of service charges for vaccines for some vaccines including Rabies, etc.

(15% service charges)

o National regulation (VDFACA) that vet drug shops (pharmacies) cannot delivery

vaccination services, while there is a need under some areas where there is little

access to the services.

o Unwillingness of local government authorities to cooperate with projects and

sometimes interfering with (and/or suppressing) the duties of the private actors

(mostly private vet service providers),

• Institutional and organizational capability to engage with the PPP

o Public sector inefficient bureaucracy my delay vaccine procurement and vaccine

delivery if vaccine is to be procured by the public sector

o Weak capacity of the private sector to participate in the delivery of vaccination

service for live vaccines

o Communities may not be paying for the proposed cost of vaccination as vaccines

are provided by the public sector free of charge or at highly subsidized rate

o Smooth communication b/n the private sector and woreda animal health office

• Availability of resources for mobile clinical service and vaccination service

Page | 27

o Available: Diagnostic equipment, (stethoscopes, thermometer), treatment

syringe, drugs, gloves, scissors,

o Not available: microscope, sterilizer, heart girth, ice box, surgical kits,

transportation

o The private sector does not have a cold chain and private transportation

means

▪ Consequences of the PPP on other actors and on the environment

o May benefit the private clinics involved in the PPP program and the other private

service providers may complain about not being involved in the PPP

Solutions for the barriers

✓ Setting regulation supporting private vaccination services

✓ Licensing the drug shop owner to allow participation in vaccination service.

✓ Letting the private sector to procure vaccines

✓ For the first phase of the PPP model, the private sector may be limited to participate in

ovine and bovine Pasteurella vaccination (dead vaccines)

✓ Cold chain facility will be provided by the public sector

✓ certifying the private service provider involved in the PPP and setting regulations.

✓ The private service providers could use public transport dead vaccines

✓ Based on demands and specific conditions (where government couldn’t reach), there is a

need to engage private sectors in specific vaccines delivery on reasonable prices and

expanding this based on lessons.

✓ Creating awareness for the community and reaching consensus on cost recovery.

✓ Private clinic owners engage in the services, forming partnership between pharmacies

and clinics on license for this services

Needs, benefits and impacts There is high need for strengthening vaccination services in all the pilot sites. There is no

public clinic or drug store at the pilot kebeles in Dire Inchini and Bati woredas (information

from field visits and consultation with livestock offices). Satisfaction of livestock keepers with

the woredas’ public services is medium to low and disease prevalence is high (Survey

reports in all pilot sites). Consultations with the PPP taskforces also indicated high need for

efficient and effective service delivery. The benefits and impacts of the models developed by

the workshop participants are documented in the various workshop reports.

Governance o A Memorandum of understanding (MoU) or contracts will be signed between

stakeholders

o The agreements may include defining the type of partnership, service types and

geographic locations, procurement of services and inputs, quality standards,

affordability of services, commitment and meeting expectations of partners to the

agreement, duration of the PPP agreement.

Page | 28

o MoUs to be signed and contents of MoUs

▪ Between private sector and woreda livestock office (Agreement on provision

of vaccination calendar and mobilization, Time frame of vaccination campaign)

▪ Between private sector and EVA for strategic deworming

▪ Between EVA and community (informal discussion)???

▪ EVA and private sector (Payment agreement for each delivered dose,

Payment ground rules (payment round, voucher they collected or initial animal

numbers agreed on?)

▪ EVA and regional labs (Assela, Bahir dar and Kombolcha labs) - Inputs

(provision of diagnostic kits, vacutainer tube, vacutainer needle, needle

holder, cryovial, cotton role, glove, alcohol, micro-pipette tips), DSA and

accommodation for sample collection and processing, Deadline to submit the

laboratory test result

o ILRI/EVA and NAHDIC

VI. Planning Households and Livestock populations in pilot sites Table 16. Pilot sites and livestock populations in pilot sites

Region Woreda Rural Kebeles HHs Cattle Shoat poultry dog Equines Camel

Oromia Dire

inchinni

Waldo hindho 600 5400 3000

Bola kalaci

Arsi

negelle Gambelto 799 9,870 5328 5438 2146

Amhara Bati Cacatu 678 3421 25,344

Banja Akena 650 3296 2516 1886 325 1308

Banja

town+environs 862 8028 2308 5,138 400 188

Somali Deghabour Bulaleh 1200 14152 35000 14152

Hargelle Oman 1400 2,641 28,000 22,621

Resource and budget requirements

Item quanti

ty unit cost beneficiary

budget

source

Vaccines 88427

dose 639,900.0

0

livestock

keepers

Private

sector

Veterinary equipment/instruments piece

s

482,250.0

0 Private clinics ILRI/EVA

Vouchers for vaccines and

treatment

2,784,037

.50

Livestock

keepers EVA

Page | 29

Lab. kits, supplies. Sample

collection/analysis

2,301,937

.50 Regional labs. ILRI

Regional labs. capacity building 8 traine

es

408,675.0

0 NADHIC ILRI

Total

6,616,800

.00

Work plan Table 16. work plan for Somali region

Activity Time frame Responsibility

MoU/contract between private sector and

woreda livestock office

Feb. and March

2021

EVA


ILRI/EVA for strategic deworming/spraying

and vaccination service

Feb and March

2021

EVA

CRA/contract between ILRI and regional

laboratory

Jan 2021 ILRI

Certification of the private sector involved

in vaccination program with renewable

certificate for specified disease within

specified area

Feb 2021 Regional and woreda

livestock resource

development office

Procurement and provision of equipment

support for the private sector

Feb and March

2021

ILRI/EVA

Starting clinical service by the private

sector

April 2021 Private service provider

Vaccination calendar preparation and

Provide vaccination calendar for the

private sector

Jan-Feb 2021 woreda livestock health

department

Procurement vaccines the campaign Feb 2021 Woreda livestock offices

and private service

provider

Awareness creation and discussion with

the community to decide on-vaccination

date

2 weeks before

campaign date

woreda livestock health

department and kebele

administration and DA

Mobilization and implementation of

strategic community-based deworming

campaign




Mobilization and implementation of

strategic community-based spraying

campaign




Page | 30

Provision of vouchers for farmers and

pastoralists

2 weeks before

campaign date

ILRI/EVA in cooperation

with kebele


Supply of diagnostic kits Mid Jan 2021 ILRI

Training one serological department

experts at NAHDIC

4th Jan 2021 ILRI

Collection of serum sample and baseline

data from Oman kebele from shoats for

CCPP pre intervention study.

Feb 2021 Jigjiga Regional

Laboratory

Collection of parasitological sample and

baseline data from Bulaleh kebele from

camel and shoats for pre intervention

study.

April 2021 Jigjiga Regional

Laboratory

Collection of serum sample and data from

Oman kebele from shoats for CCPP post

intervention study.

April 2021 Jigjiga Regional

Laboratory


data from Bulaleh kebele from camel and

shoats for pre intervention study.

May 2021 Jigjiga Regional

Laboratory


data from Oman kebele from camel, cattle

and shoats for pre intervention study.

May 2021 Jigjiga Regional

Laboratory

Collection of parasitological sample and

data from Bulaleh kebele from camel and

shoats for post intervention study.

June 2021 Jigjiga Regional

Laboratory

First reporting June 30th , 2o21 Jigjiga Regional

Laboratory


Bulaleh kebele from camel and shoats for

post intervention study

July 2021 Jigjiga Regional

Laboratory


Oman kebele from camel, cattle and


July 2021 Jigjiga Regional

Laboratory

Final reporting August 30th , 2021 Jigjiga Regional

Laboratory

Monitoring and evaluation (adopt/develop

tool)

June to Dec 2021 EVA/ILRI, regional

HEARD team, regional

lab.

Table 17. Work plan for Amhara region


Page | 31



Feb. and

March 2021

EVA




Feb and

March 2021

EVA


laboratory

Jan 2021 ILRI

Certification of the private sector involved in

vaccination program with renewable

certificate for specified disease within

specified area


livestock resource

development office



Feb and

March 2021

ILRI/EVA

Starting clinical service by the private sector April 2021 Private service provider

Vaccination calendar preparation and Provide

vaccination calendar for the private sector

Jan-Feb

2021


department

Procurement vaccines the campaign Feb 2021 Woreda livestock offices

and private service

provider

Awareness creation and discussion with the

community to decide on-vaccination date

2 weeks

before

campaign

date




Mobilization and implementation of strategic

community-based deworming campaign





community-based spraying campaign





pastoralists

2 weeks

before

campaign

date


with kebele administration

and DA

Supply of diagnostic kits Mid Jan 2021 ILRI

Training two serological department experts

at NAHDIC

4th January

2021

ILRI

Collection of fecal sample and baseline data

from Akena and Zufari kebele from cattle and


14 May 2021

Bahir-Dar regional

laboratory

Page | 32

Collection of fecal sample and other data from

Akena and Zufari kebele from cattle and


1st June

2021

Bahir-Dar regional

laboratory

1st round reporting July 2021 Bahir-Dar regional

laboratory

Collection of serum sample and baseline data

from Akena and Zufari kebele from cattle for

pre intervention study.

September

2022

Bahir-Dar regional

laboratory

Collection of serum sample and other data

from Akena and Zufari kebele from cattle for

post intervention study.

November

2022

Bahir-Dar regional

laboratory


from Akena and Zufari kebele from poultry for


February

2021

Bahir-Dar regional

laboratory


from Akena and Zufari kebele from poultry for


March 2021

Bahir-Dar regional

laboratory


from Cacatu kebele from cattle and shoats for


5 April 2021 Kombolcha Regional

Laboratory


from Cacatu kebele from cattle and shoats for


27 May 2021 Kombolcha Regional

Laboratory

Reporting 30th June

2021

Kombolcha Regional

Laboratory

2nd round reporting 15th July

2021

Bahir-Dar regional

laboratory


tool)

June to

December

2021

EVA/ILRI, regional


lab.

Final reporting August 30th ,

2021

Kombolcha and B.Dar

Lab. Regional Laboratory


tool)

June to Dec

2021

EVA/ILRI, regional


lab.

Table 18. Work plan for Oromia region




Feb. and

March 2021

EVA

Page | 33




Feb and

March 2021

EVA


laboratory

Jan 2021 ILRI

Certification of the private sector involved in

vaccination program with renewable certificate

for specified disease within specified area


livestock resource

development office



Feb and

March 2021

ILRI/EVA

Starting clinical service by the private sector April 2021 Private service provider

Vaccination calendar preparation and Provide

vaccination calendar for the private sector

Jan-Feb

2021


department

Procurement vaccines Feb 2021 Woreda livestock offices

and private service

provider

Awareness creation and discussion with the

community to decide on-vaccination date

2 weeks

before

campaign

date





community-based deworming campaign





community-based spraying campaign





pastoralists

2 weeks

before

campaign

date


with kebele administration

and DA

Supply of diagnostic kits Mid Jan

2021

ILRI

Training two serological department experts at

NAHDIC

4th January

2021

ILRI


from Gambelto kebele from cattle and shoats

for pre intervention study.

24 February

2021

Assela Regional

Laboratory

Collection of fecal sample and data from

Gambelto kebele from cattle and shoats for


14 March

2021

Page | 34


from Waldo hindho kebele from cattle and


28 March

2021

Assela Regional

Laboratory




23 May 2021

Assela Regional

Laboratory




14 May 2021

Assela Regional

Laboratory

Collection of fecal sample and other data from

Waldo hindho kebele from cattle and shoats

for post intervention study.

1st June

2021

Assela Regional

Laboratory


from Gambelto kebele from cattle and shoats

for pre intervention study.

24 February

2021

Assela Regional

Laboratory

Final reporting August 30th ,

2021

Assela Regional

Laboratory

Monitoring and evaluation (adopt/develop tool) June to Dec

2021

EVA/ILRI, regional


lab.

Monitoring and evaluation The OIE PPP model development tool will be followed to collect relevant data. FGDs will also

be held with women and men farmer/pastoralist groups in for mid-term and final evaluation.

Data on sero-prevalence and sero-conversion of vaccination interventions, pre-intervention

EPG assessment and mortality/morbidity, diseases observed, and performance levels will be

collected to be compared with post-intervention disease status and performance levels.

Similar data will be collected periodically and at the end of the intervention. Additionally,

participatory evaluation with farmers/pastoralists in FGDs. The FGDs evaluate on

accessibility, affordability, and quality of services on 1 to 10 scale. The checklists for the FGD

are attached.

• Data types and methods:

o Evaluation of vaccination services - laboratory tests (serology for respiratory

diseases) pre- and post-vaccination (sero-conversion), pre and post intervention EPG

assessment. The

o Mortality data

o Morbidity data - disease scoring based on clinical signs. The data to be collected are

number of animals showing each clinical sign in each herd by sex and age group

(guide/list of clinical signs to be prepared), severity of signs (severe, mild, minor)

o Similar data will be collected quarterly after interventions are introduced

Page | 35

• The regional HEARD team and PPP taskforce will be involved in supporting and

monitoring of the activities

• The ILRI and EVA HEARD team will make a Quarterly visit

• Mid-term and final assessment to be conducted to evaluate the success/failure

▪ data on costs and benefits for cost-benefit analysis will be collected to evaluate

profitability of the interventions for the private sector.

▪ Cost-benefit analysis to be conducted to determine the profitability of the private

veterinary businesses which determines the sustainability of the interventions.

▪ A monitoring and evaluation framework with indicators and targets will be developed

Annex I: Priority diseases and health services

Figure 1. Per cent of respondents reporting their first priority cattle disease within each disease

category in four woredas in each of Oromia (a) and Amhara (b) regions of Ethiopia [LSD lumpy

skin disease, GIT gastro-intestinal tract]

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Pas

teu

rello

sis

Pn

eu

mo

nia

Co

ugh

ing

no

ne

Rab

ies

no

ne

LSD

Der

mat

op

hilo

sis

oth

er

no

ne

Live

r fl

uke

Hae

mo

nch

osi

s

Bab

esio

sis

Dia

rrh

ea

no

ne

Man

ge m

ite

Tick

no

ne

Lice

An

thra

x

Bla

ck le

g

Bo

vin

e TB

Co

wd

rio

sis

FMD

no

ne

respiratory Neurological Skin diseases GIT parasite External parasite Systemic diseases

Arsi-Negelle Dire-Inchini Fentale Jimma-Arjoo

0.0%

50.0%

100.0%

150.0%

200.0%

250.0%

300.0%

350.0%

Pas

teu

rello

sis

no

ne

Pn

eu

mo

nia

Co

ugh

ing

no

ne

Rab

ies

LSD

Der

mat

op

hilo

sis

no

ne

Live

r fl

uke

Hae

mo

nch

osi

s

no

ne

Bab

esio

sis

Dia

rrh

ea

Lun

g w

orm

Man

ge

Tick

no

ne

Lice

An

thra

x

Bla

ck le

g

Co

wd

rio

sis

FMD

no

ne

Tryp

ano

som

iasi

s respiratory Neurological Skin diseases GIT parasite External parasite Systemic diseases

% o

f re

spo

nd

ents

Angolela Banja Bati Sekota

b

a

0.0% 50.0% 100.0% 150.0% 200.0% 250.0% 300.0%

swelling of headPasteurollosis

CoughingPneumonia

noneCCPP

Wugat

Coenurosisnone

Ostrous ovisRiqannoota

noneOrf

Qoda BeshitaSheep and goat pox

ye hodtilHaemonchosis

Liver flukeLung worm

noneDiarrhea

MangeTick

noneLice

Sheep ked

AnthraxBlack leg

FMDnone

PPRGeneral septicemia

res

pir

ato

ry N

eu

rolo

gica

l S

kin

dis

ease

s G

IT p

aras

ite

Ext

ern

al p

aras

ite

Sys

tem

ic d

isea

ses

Amhara


Figure 2. Per cent of respondents reporting their first priority sheep diseases in each of the six

disease categories in six woredas of Oromia and Amhara regions of Ethiopia

0.0% 50.0% 100.0% 150.0% 200.0% 250.0%

swelling of headPasteurollosis

CoughingPneumonia

noneCCPP

Wugat (Koyoo)

Coenurosisnone


noneOrf

otherQodaBeshita

Sheep and goat pox

yehod tilHaemonchosis


noneDiarrhea

MangeTick

noneother

LiceSheep ked

AnthraxBlack leg

FMDnone


res

pir

ato

ry N

eu

rolo

gica

l S

kin

dis

ease

s G

IT p

aras

ite

Ext

ern

al p

aras

ite

Sys

tem

ic d

isea

ses

OROMIAArsi-Negelle Dire-Inchini Fentale Jimma-Arjoo

0.0% 50.0% 100.0% 150.0% 200.0% 250.0%

CCPPCoughing

wugatinone

pasteurellosisPneumonia

swelling of head

Coenurosisnone


noneOrf

QodaBeshitaSheep and goat pox

ye hodtilHaemonchosis


abdominal fluidnone

Diarrhea

MangeTick

noneLice

Sheep ked

AnthraxBlack leg

FMDnone


res

pir

ato

ryN

eu

rolo

gica

l S

kin

dis

ease

s G

IT p

aras

ite

Ext

ern

al p

aras

ite

Sys

tem

icd

isea

ses

Oromia


Figure 3. Per cent of respondents reporting their first priority goat diseases in each of the six

disease categories in six woredas of Oromia and Amhara regions of Ethiopia [results from

Angolela-Tera, Banja and Dire inchini woredas should be disregarded as the number of

respondents were too few]

0.0% 50.0% 100.0% 150.0% 200.0% 250.0% 300.0%

Coughing

wugati

none

pasteurellosis

Pneumonia

swelling of head

CCPP

Coenurosis

none

Ostrous ovis

Riqannoota

none

Orf

Sheep and goat pox

ye hodtil

Haemonchosis

Liver fluke

Lung worm

none

Diarrhea)

Mange

Tick infestation

none

Lice

Sheep ked

Anthrax

Black leg

FMD

none

other

PPR

General septicemia

res

pir

ato

ry N

eu

rolo

gica

l S

kin

dis

ease

s G

IT p

aras

ite

Ext

ern

al p

aras

ite

Sys

tem

ic d

isea

ses

Amhara


Figure 4. Proportions (%) of chicken keepers reporting their priority diseases in eight woredas in

Oromia and Amhara regions of Ethiopia

Table 1. Proportion (%) of respondents reporting access to animal health service providers in

four woredas of Oromia and Amhara regions in Ethiopia

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Newcastledisease

Gumboro Avian influenza internalparasites

externalparasites

none

Oromia


0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Newcastledisease

Gumboro Avian influenza internalparasites

externalparasites

none

Amhara


Amhara Oromia

Angolel

a-Tera

Banj

a Bati Sekot

a

Zuria

Dire-

inchi

ni

Fental

e

Jimm

a -

Arjo

Arsi-

Negell

e Community animal health

workers

10.0

Animal health assistant

(kebele posts)

28.3 100.

0

50.0 96.7 37.7 98.3 100.0 100.0 Livestock extension agent 63.3 100.

0

100.

0

88.3 91.8 51.7 98.3 100.0 Local/ traditional healer 21.7 60.0 13.9 16.7 3.3 58.3 15.0 100.0 Veterinary drug store 78.3 48.3 100.

0

78.7 100.0 48.3 100.0

Private veterinarian 6.7 50.0 19.4 52.5 68.3 48.3

Official (Public)

veterinarian (woreda vets)

71.7 50.0 100.

0

68.3 91.8 91.7 85.0 100.0

Table 2. Satisfaction (score out of 10) of livestock keepers with services provided by different

sources during the survey year in in four woredas in Amhara and Oromia regions of Ethiopia

CAHWs AHA LEA healer Drug store Pvt vet Pub. vet

Angolela-Tera-

tera

7.68 7.53 7.37 5.81 6.82 7.53

Arsi Negelle

6.25 7.44 5.73 6.05 6.50 7.01

Banja

8.31 8.34 7.40 7.93 6.07 8.35

bati

5.86 5.90 6.15 6.36 6.44 5.97

dire inciinii

3.32 3.94 3.95 3.30 5.42 3.86

Fentale 6.5 7.20 8.13 5.23

6.39 7.48

jimma arjoo

6.65 5.45 5.71 5.57 4.32 6.08

Sekota Zuria

zuria

7.78 7.61

4.93 7.81

Overall 6.5 6.93 6.72 5.81 5.70 5.85 6.86

Accessibility included affordability.

Table 3. Proportions of camel herds affected and died of (case fatality) camel diseases

identified by female and male focus group discussions in Hargelle woreda of Somali region,

Ethiopia

Male FGD Female FGD

Local name Veterinary name

%

affecte

d

Case

fatality (%)

%

affected

Case

fatality

(%) average Rank

Respiratory

diseases

Kench

Hemorrhagic

septicemia/Pasteure

llosis 40 15

45 56

42.5 7

GerAduhf

respiratory

syndrome 100 10 90 22.22 95 1

Neurological

diseases 0 16

Gudan

Neurological

disorder 24 7 12 15

Skin diseases 0 16

Achiro Camel pox 66 19 65 38.56 65.5 4

Ambar Dermatophilosis 30 0 10 0 20 14

GIT parasites 0 16

Elle/gorialle camel GIT 100 40 60 ?? 80 3

Suki diarrheal disease 55 15 27.5 10

Dugetu

Coughing, fever,

lung worm? 80 0 40 8

External

parasites 0 16

Addo camel mange mite 77 9 100 0 88.5 2

shilin tick 100 0 50 6

Systemic

diseases

0 16

dhukhan Trypanosomiasis 89 10 25 20 57 5

Kutke Anthrax 42 24 21 13

Other diseases 0 16

Deleco

camel contagious

necrosis 43 6 21.5 12

camel brucellosis 73 3 36.5 9

Andobarar camel mastitis 30 0 25 0 27.5 10

Table 4. Proportions of camel herds affected and died of (case fatality) camel diseases

identified by female and male focus group discussions (FGD) in Degehabour woreda of Somali

region, Ethiopia

Male

FGD

Female

FGD

Ove

rall

Ra

nk

Respiratory diseases

Morbidit

y (%)

case

fatality

(%)

Morbidit

y (%)

case

fatality

(%)

Middle East respiratory

syndrome (MERS) geraduuf 100 10 100 15 100 1

Pasteurellosis kancha 40 37.5 65 23 52.5 6

lung worm (Coughing) dugatto 80 0 40 7

Neurological complex 0 11

Skin diseases 0 11

camel -pox

achirro/Furq

ageele

70 14.3-57.2 70 42.85

70 4

Dermatophilosis ambahar 30 0 20 0 25 9

GIT parasite 0 11

general septicemia gorian/A'al 100 4 20 15 60 5

External parasite 0 11

Mange mite A'ddoo 100 0 100 0 100 1

Tick infestation shilin 100 0 100 0 100 1

Systemic diseases 0 11

Trypanosomiasis dhukhan 34 0 40 25 37 8

other diseases 0 11

mastitis Andobara 30 0 20 0 25 9

Table 5. Proportions of sheep and goat flocks affected and died of (case fatality) sheep and

goat diseases identified by female and male focus group discussions (FGD) in Hargelle woreda

of Somali region, Ethiopia

Local name

Veterinary

name % affected

Case fatality

(%)

%

affecte

d

Case fatality

(%)

Over

all

Ran

k

Har PPR 50 25 90 61 70 5

Gereduf

Male FGD:

Respiratory

complex,

Female

FGD:Nasal

discharge 100 50

100 70

100 1

Sambab/Kuf

fa CCPP 30 15 100 36 65 6

Farka Adiga

sheep and

goat Pox 100 50-80

100 40

100 1

Hulumbie

Nairobi sheep

disease 100 50

50 8

Boode Pasteurellosis 80 40 89 40 84.5 4

Raf dilea foot rot 10 0 5 12

Gestheri

male:

Coenerosis/o.

ovis, Female:

Myiasis (o.

ovis) 30 20

20 10

25 9

Shilin tick 100 80 100 0 100 1

gorian/A'al GIT 20 10 100 0 60 7

Ambahaar/

Gubatto

Dermatophilosi

s

10 0

5 12

FMD 38 21 19 10

rimaayat abortion 38 0 19 10

Table 6. Proportions of sheep and goat flocks affected and died of (case fatality) sheep and

goat diseases identified by female and male focus group discussions (FGD) in Degahabour

woreda of Somali region, Ethiopia

Veterinary name Local name Morbidity

(%)

case

fatality

(%)

Morbidity

(%)

case

fatality

(%)

Overall Rank

respiratory diseases

Nasal discharge geraduuf 100 50 74 56.75 87 3

Pasteurellosis boode 80 50 40 5

CCPP sambab 30 50 40 62.5 35 6

Neurological 0 10

0 10

Skin diseases 0 10

Sheep and goat

pox Fur gadiga 100 65 85 22 92.5

2

orf Af-garfow 30 13.33 15 8

GIT parasite 0 8

general gorian/A'al 20 50 30 66.6 25 6

External parasite 0 7

Tick infestation shilin 100 80 100 15 100 1

myiasis (Oestrus

ovis) geeste heeri 30 66.66 50 20 40

3

Systemic diseases 0 5

PPR haar 50 50 80 75 65 2

Nairobi sheep

disease hulumbe 100 50 60 50 80

1

FMD Abeb 70 21.4 35 1

other diseases 0 2

foot rot raaf dila'aa 10 0 25 0 17.5 1

Table 7. Pastoralists willingness to pay for animal health services in Hargelle woreda of Somali

region, Ethiopia

Species Service

Service

provider

FGD

group

No. of

participants

WTP

(vote, %)

Birr/a

nimal

Camel vaccination private Male 10 80 30.00

public Male 10 NA NA

Treatment

(antibiotics) private Male 10 60 40.00

External

parasite

(ivermectin) private Male 10

3.50

External

parasite

(spray) private Male 10 80 50.00

Sheep/g

oat vaccination private Male 10 90 7.50


Treatment

(antibiotics) private Male 10 70 10.00

public Male

External

parasite

(spray)

Male 10 90 3.00

Cattle vaccination

Male 10 50 20.00

Treatment

(antibiotics)

Male 10 50 25.00

External

parasite

(spray)

Male 10 80 30.00

Camel vaccination private Female 10

3.00

public Female 10

1.50

Treatment

(antibiotics) private Female 10 100 20.00

public Female 10 100 10.00

External

parasite

(Ivermectin) public Female 10 100 3.00

private Female 10 10 5.00

External

parasite

(acaricide

spray) public Female 10

100

1.00


Sheep/g

oat vaccination private Female 10

100

3.00


Treatment

(antibiotics) private Female 10

100

5.00


External

parasite

(spray) public Female 10

100

1.00


External

parasite

(ivermectin) public Female 10

100

0.50


Table 8. Willingness of pastoralists to pay for animal health services in Degehabour woreda of

Somali region, Ethiopia

Species Service

Service

provider

FGD

group

No. FGD

participant

s

WTP

(vote, %) Birr/animal

camel

Treatment with

Antibiotic public Male 10 100% 10.00

private Male 10 100% 20.00

vaccination public Male 10 100% 1.50


sheep/g

oat

Ivermectine

injection public Male 10 100% 3.50


Spraying acaricide public Male 10 100% 1.00

private Male 10 100% 3

shoat

Treatment with





Ivermectine





Table 9. Satisfaction scoring (out of 10) of pastoralists and agropastoralists with health service

providers in Somali region, Ethiopia

Accessibility Affordability Quality Timeliness

CAHWs

Pastoralist 6.36 6.55 6.79 6.13

Agropastoralist 6.32 6.72 6.88 6.72

Livestock agent

Pastoralist 6.94 6.81 7.00 6.97


Traditional healer

Pastoralist 5.00 5.00 8.00 7.00


Drug store

Pastoralist 5.76 5.68 6.00 5.71


Private vets

Pastoralist 6.73 7.64 8.55 7.64


Public vets

Pastoralist 6.50 5.00 5.00 5.00


[Source: Gebremedhin et al. (2017) RPLRP project report]

Annex II: Willingness to pay for services Table 10. Pastoralist’s willingness to pay for animal health services in Hargelle woreda of


Species Service

Service

provider

FGD

group

No. of

participant

s

WTP

(vote, %)

Birr/an

imal

camel vaccination private Male 10 80 30.00


Treatment (antibiotics) private Male 10 60 40.00

External parasite

(ivermectin) private Male 10

3.50

External parasite

(spray) private Male 10 80 50.00

sheep/g

oat vaccination private Male 10 90 7.50


Treatment (antibiotics) private Male 10 70 10.00

public Male

External parasite

(spray)

Male 10 90 3.00

cattle vaccination

Male 10 50 20.00

Treatment (antibiotics)

Male 10 50 25.00

External parasite

(spray)

Male 10 80 30.00

camel vaccination private Female 10

3.00

public Female 10

1.50

Treatment (antibiotics) private Female 10 100 20.00


External parasite

(Ivermectin) public Female 10 100 3.00


External parasite

(acaricide spray) public Female 10

100

1.00


sheep/g

oat vaccination private Female 10

100

3.00


Treatment (antibiotics) private Female 10 100 5.00


External parasite

(spray) public Female 10

100

1.00


External parasite

(ivermectin) public Female 10

100

0.50


Table 11. Willingness of pastoralists to pay for animal health services in Degehabour woreda of


Species Service

Service

provider

FGD

group

No. FGD

participant

s

WTP

(vote, %) Birr/animal

camel

Treatment with





sheep/g

oat

Ivermectine





shoat

Treatment with





Ivermectine





'This publication was produced with the financial support of the European Union. Its contents

are the sole responsibility of the International Livestock Research Institute and Ethiopian

Veterinary Association and do not necessarily reflect the views of the European Union'

The Health of Ethiopian Animals for Rural Development (HEARD) project is financed

by the European Union.

Among others, one of the objectives of the project, ‘improving the technical

competencies of veterinary service providers to enable them to deliver better and

provide rationalized services’ is jointly implemented by the International Livestock

Research Institute (ILRI) and the Ethiopian Veterinarians Association (EVA). The lead

implementer of the HEARD project is the Federal Democratic Republic of Ethiopia’s

Ministry of Agriculture.

Lead implementer

Funded by the European Union

Component 2 of the HEARD project is

implemented by

Documents

Public-Private Partnership (PPP) for delivery of animal